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Income Benefits

1. My doctor has taken me off work due to my injury. I have received no benefits and my bank account is draining fast. What can I get to replace lost wages?

You are eligible to receive workers' compensation "temporary income benefits" (TIBS) if you meet certain requirements. Generally, those will be that (1) the insurance company has accepted your injury as compensable (i.e. covered and benefits are payable) (2) you are unable to do enough of your regular work or any light duty work offered in writing by the company to make the wages you earned before you got hurt and (3) you have not reached maximum medical improvement.

If any of those requirements is not met, you may be eligible for other benefits, either through workers' compensation or other sources. Check with an attorney to find out how.

2. What income benefits am I entitled to when I am hurt at work?

There are several categories of benefits.

The first and most common is temporary income benefits (TIBS).

TIBS are payable when you have a compensable injury, are disabled, and have not reached maximum medical improvement.

TIBS are payable when you are unable to obtain and retain employment due to a compensable injury, you have not reached maximum medical improvement as certified by a doctor, and you do not have your salary continued by the employer. TIBS are paid at the rate of 70% of your pre-injury average weekly wage in most cases. If you receive a low hourly wage, you may receive benefits at 75% for a period of time.

3. I'm not just disabled from my work where I got hurt. I had a second job and my injury keeps me from working there, also. I'm losing pay from both jobs. What can I do?

If you had a second job when you got hurt and you are eligible for income benefits of any kind, you can request that the insurance company factor in the wage rate from your second job to your benefits.

This applies even if you never lose time from that second job-- because your second job will increase the rate at which (for example) impairment income benefits are paid.

In order to get the insurance to pay those benefits, you must collect specific wage information on a form (DWC-3ME) that must be certified by someone who works for that employer. If you had a second job working perhaps as a contractor, the insurance still may have to add those wages to your benefits, but you are likely to face a battle from them, since they may assume your request is fraudulent unless presented with solid proof.

4. How will I get paid?

The payment schedule varies by benefit type, but the insurance company will generally pay you weekly benefits while you are disabled and eligible for TIBS.

These benefits are paid by check that should be sent not later than the last date it is supposed to cover. The insurance company does not need to ensure that your check arrives at a certain time of the week or month. They are not responsible for postal delays. Often the adjuster may forget to issue your check. If this happens frequently, you may want to report the violation to the TDI-DWC.

If you are eligible for benefits over an extended period of time, you can request payment by direct deposit. The insurance carrier will require bank information in order to process this request and it may take weeks to set up. You may also ask to be paid monthly.

If the insurance carrier is ordered to pay you past due benefits by a hearing officer, they have a deadline specified in the law and they must pay promptly, plus interest, all benefits ordered. If they fail to pay what the hearing officer orders, you can sue them and collect all benefits due, plus interest, plus a penalty, and attorney's fees. Check with an attorney if you believe the insurance has shorted you in paying benefits.

If the insurance carrier agrees to pay you by written agreement approved by the TDI-DWC (usually on a form DWC-24), they have 5 business days to cut you a check unless agreed otherwise. As always, that refers to the date of mailing, not the date you receive payment.

5. What are the different income benefit types?

There are four basic types: temporary income benefits (TIBS), impairment income benefits (IIBS), supplemental income benefits (SIBS), lifetime income benefits (LIBS) and death income benefits (DIBS).

SIBS are paid if you have at least a 15% impairment rating, the impairment benefits have expired, and you meet the filing criteria for a given thirteen week "qualifying period."

LIBS are paid when you have a severe injury that fits into one of several special categories written into the law.

6. How are Impairment Income Benefits determined and paid?

IIBS are paid when you have reached maximum medical improvement and are paid based upon your assigned impairment rating.

7. How are Supplemental Income Benefits determined and paid?

SIBS are paid if you have at least a 15% impairment rating, the impairment benefits have expired, and you meet the filing criteria for a given thirteen week "qualifying period."

8. How are Lifetime Income Benefits determined and paid?

LIBS are paid when you have a severe injury that fits into one of several special categories written into the law.

9. How are Death Income Benefits determined and paid?

DIBS are paid when you are an eligible beneficiary of a worker who either died on the job, sustaining a compensable death, or died as a direct and natural result of the original compensable injury.

Contact San Antonio Workers Compensation and Accident Lawyer Alan Tysinger

Suffering an on the job injury or losing a loved one to an accident is an emotional and difficult challenge. Battling with insurance and getting the right legal answers is something you won't want to do alone. Attorney Alan Tysinger has experience and know-how to get to the truth of your injury case and hold the insurance or employer accountable. You can get a free consultation with a personal injury lawyer in San Antonio by calling toll-free 866-957-2667 or send a message online.